1. Field of the Invention
The invention relates to surgical devices and procedures and is directed more particularly to a device for repairing arteries.
2. Description of the Prior Art
FIG. 3a depicts a representation of an artery A occluded by atherosclerotic plaque P. In performing an endarterectomy, the artery is incised (FIG. 3b) over the occluded site S and the plaque P removed (FIG. 3c). After the plaque has been removed, it is necessary to taper the edges of the plaque P remaining in the unincised distal portion of the artery Ad, to minimize the possibility of thrombus formation and/or peripheral embolization. After tapering the plaque P, a venous catheter is selected having an outside diameter comparable to the desired lumen diameter of the artery A. The catheter is pointed by making a diagonal cut across its diameter (not shown). The catheter is then guided, point-first, into the incision and its point piloted in the distal intact artery Ad (not shown). The catheter thereby acts to support the artery, thus maintaining the lumen diameter while a venous patch is sewn over the incision. The patch is sewn into place over the catheter until only enough of the incision remains unclosed to permit escape of the catheter. The catheter is then withdrawn and the patch closed, thereby completing the endarterectomy.
The above procedure presents certain problems.
Tapering the distal plaque must be done in order to provide a gradual change in vessel lumen diameter and to eliminate any ridge or shelf for thrombus formation. Presently, distal plaque is extracted by use of forceps, frequently leaving a rough edge and oftentimes affecting a less than complete extraction of plaque.
Proper centering of the catheter in the artery or vessel is helpful in that the catheter acts as a form which supports the incised portions of the artery and a patch to be sewn thereto, facilitating alignment of the incised portions and the patch. Under present procedures, the catheter is cut on an angle, creating an eccentric point, and inserted into the distal portion of the artery. Inasmuch as the point is eccentric, being on the periphery of the catheter, it encounters irregularities on the inside wall of the artery, such as deposits of plaque and is displaced inwardly of the arterial wall, carrying the catheter to an eccentric position.
In patching the incision, the soft catheter at the site of the patch often is penetrated by the needle, interfering with a clean accurate suturing operation.